Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

4 - misc > ooh surgery wow > Flashcards

ooh surgery wow Flashcards

1
Q

What is body dysmorphobia?

A

Pt has a preoccupation with a defect of appearance
This leads to significant distress
Leads to associated mental disorders eg - anorexia nervosa
If pt isn’t happy with their face - orthognathic surgery won’t help them

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Who is involved in the MDT for orthognathic surgery?

A

Psychologist
Orthodontist
Maxillofacial surgeon
Technologies
Restorative dentist
SLT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What should be considered in history for orthognathic surgery?

A

Congenital cause
Acromegaly - hormone with adenoma in pituitary
Pathology - cysts and tumours
Racial characteristics - don’t need to be changed
Psychological motivation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What 3 points of reference must be recorded on a facebow?

A

Condylar heads
Orbitale
Maxillary dentition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How is 3D planning carried out for orthognathic surgery?

A

Soft tissues imaging - stereophotogrametry
Skeletal tissue - CBCT
Dental tissue - intra-oral scan
All compiled together for a pt image

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What maxillary problems may need orthognathic surgery?

A

Prognathic or retrognathic
Vertical excess or deficiency
Narrow or wide
Asymmetry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What mandibular problems may need orthognathic surgery?

A

Prognathic or retrognathic
Asymmetry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What chin problems may need orthognathic surgery?

A

Progenia or retrogenia
Vertical deficiency or excess
Asymmetry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the stages of tx before and after orthognathic surgery?

A

Tooth alignment, eliminate crowding spaces and crossbites
Coordination of arches
Decompensation of incisors (correcti inclination)
Flatten occlusal plane
Surgical fixation
Post-surgical ortho fine-tuning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What orthognathic surgeries can be carried out for the maxilla?

A

Le Fort I osteotomy
Anterior maxillary osteotomy
Posterior maxillary osteotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is a Le Fort I osteotomy?

A

Disarticulating maxilla from base of skull and move it to a pre-planned position
Moves superiorly, inferiorly and forward
Cannot be moved posteriorly due to pterygoid plates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What orthognathic surgery is carried out for the mandible and what are the steps?

A

Sagittal split mandibular osteotomy
Separate the ramus from the body
Body can be moved in any direction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What orthognathic surgery is carried out for the chin and what are the steps?

A

Genioplasty
Inferior border of the mandible can move in any direction
Advancement, set-back and rotation
Augmentation and reduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the signs and symptoms of mandibular fracture?

A

Pain, swelling, limitation of function
Occlusal derangement
Numbness of lower lip
Mobile teeth
Bleeding
Anterior open bite
Facial asymmetry
Deviation of the mandible to the opposite side
Step deformity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How do the muscles cause mandibular displacement?

A

Muscles work in opposite directions
Masseter, temporalis and medial pterygoid elevate the mandible and geniohyoid and anterior belly of digastric depress the mandible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How are mandibular fractures classed based on surrounding tissue involvement?

A

Simple - soft tissue intact
Compound - affects surrounding soft tissue
Comminuted - bone broken into multiple small pieces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the different sites of mandibular fracture?

A

Angle
Subcondylar
Parasymphyseal
Body
Ramus
Coronoid
Condylar (intra or extra capsular)
Alveolar process

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How are mandibular fractures classed based on the direction of the fracture line?

A

Favourable - minimises displacement
Unfavourable - encourages displacement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What factors cause mandibular displacement?

A

Direction of fractures line
Opposing occlusion
Magnitude of force
Mechanism of injury
Intact soft tissues
Other associated fractures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What radiographs are used in mandible fractures?

A

PA mandible and OPT - right angles to each other
CBCT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How are mandibular fractures treated?

A

Control pain and infection
Reduction - putting segments in correct anatomical position
Fixation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the options for fixation?

A

Closed reduction and fixation (IMF)
ORIF - open reduction and internal fixation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the difference between open and closed reduction?

A

Open - expose bony areas surgically and reduce them directly with vision - most common
Closed - don’t open the fracture, you depend on the occlusion to guide the fracture into the correct alignment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the 5 surgical approaches for mandibular fractures?

A

Retro-mandibular approach
Raised on approach from inferior border
Pre auricular approach
Bicoronal flap - from one ear to the other
Endoscopic reduction and fixation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is a step deformity?
An irregularity in the alignment of adjacent bone segments causing a visible or palpable step-like change in the bone contour Sign of mandibular fracture
26
What is often used for Xenografts?
Bio-Oss (Deproteinised bone matrix)
27
What are the principles of grafting?
Osteoconduction - the concept of scaffold that supports the bone forming cells Osteoinduction - osteogenesis is induced through the recruitment of immature cells for bone formation
28
What local sites are used for bone grafting?
Chin Ramus Tuberosity Coronoid process
29
What distant sites are used for bone grafting?
Iliac crest Calvarium
30
What is the advantage of Bio-Oss?
Minimises resorption
31
What is applied after Bio-Oss?
GTR Guided tissue regeneration membrane
32
What is an inter-positional graft?
Bone graft applied between inner and outer cortex to increase bone width
33
What is distraction osteogenesis?
Cutting bone (osteotomy), separating it to create a gap and then stretching the soft tissue to form bone from within
34
What are the steps of distraction osteogenesis?
Osteotomy Latency - waiting for inflammatory cells to infiltrate and for soft tissue healing Distraction (lengthening) Consolidation - leave device in to hold bone in place Bone remodelling
35
How is lengthening carried out in distraction osteogenesis?
Using a device, a key is turned so there is 1mm movement per day, 0.5mm in the morning, 0.5 in afternoon
36
Why os 1mm the max movement per day in distraction osteogenesis?
Any more would result in fibrous healing
37
What are the indications for zygomatic implants?
Severe maxillary atrophy Sinus pneumatisation (increase in volume) Avoids harvesting of bone graft Hemimaxillectomy
38
What is BMP and how does it work?
Active osteoinductive factor Extra-cellular protein stored in bone matrix Contains cytokines that convert immature cells into osteoblasts stimulating bone formation
39
How are maxillofacial fractures classed?
1. Naso ethmoidal 2. Lateral middle third (zygomatic) 3. Central middle third 4. Mandibular
40
What are the different central middle third fractures?
1. Nasal bone 2. Unilateral maxillary fracture 3. Le Fort 1 4. Le Fort II 5. Le Fort III 6. Combinations
41
What makes up the orbito nasal ethmoid complex?
Anterior wall Medial wall Lateral wall Floor Apex Roof
42
What is found in the medial wall of the orbito nasal ethmoid complex?
Medial rectus Nose Lacrimal duct and sac Medial canthal ligament Ethmoid sinus Cribriform plate
43
What is in the superior orbital fissure?
CN III CN IV CN VI Ophthalmic nerve branches Ophthalmic veins
44
What is in the inferior orbital fissure?
Infraorbital nerve Infraorbital vein Infraorbital artery
45
What are the signs of Malar (zygomatic) fractures?
Periorbital bruising Subcutaneous emphysema Epistaxis Step deformity Infraorbital sensory deficit Diplopia
46
How are orbito nasal ethmoid injuries managed definitively?
Review once swelling subsided Further radiographs, possible CT Informed consent Closed reduction and possibly fixation ORIF
47
Why would a zygomatic fracture cause limited mouth opening?
It’s impinging on the coronoid process
48
What approaches can be used for zygomatico orbital fractures to reduce scarring?
Howard Gillies approach Trans-conjunctival approach Bi-coronal approach
49
What is found in the floor of the orbit?
Infraorbital nerves and vessels Antrum Nasolacrimal canal Inferior rectus and oblique muscles
50
What are the signs of floor of orbit fracture?
Enophthalmos - posterior displacement of eyeball Diplopia Infraorbital numbness Antro-orbital communication Naso-lacrimal duct damage
51
What anatomy is found in the lateral orbit wall?
Lateral canthal ligament and muscle CNVI Lateral rectus Middle cranial fossa Dura and temporal lobe
52
What are the signs of lateral wall fracture of the orbit?
Exophthalmos - protrusion of eyeball Inward displacement Lateral canthal displacement Lateral rectus palsy
53
What anatomy is found in the roof of the orbit?
Anterior cranial fossa Dura and frontal lobe Superior rectus and oblique Frontal sinus Supraorbital nerve
54
What are the signs of orbital roof fracture?
Dural tear and brain damage CSF leak Trochlear damage Diplopia Frontal anaesthesia Exophthalmos
55
What anatomy is found at the apex of the orbit?
Optic nerve Ophthalmic nerve and artery
56
What are the signs of apex fracture?
Blindness
57
What are the signs of medial wall fracture?
Nasal shortening Bridge depression Telecanthus Diplopia CSF leak Cribriform plate damage Naso-lacrimal apparatus damage Medial displacement of eyeball
58
How are trauma cases assessed?
A - airway and C spine control B - breathing C - circulation and haemorrhage control D - disability (head injuries, GCS)
59
What are the reasons for treating fractures?
Aesthetics Prevent wound infection Chronic sinusitis (up to 60% chance) Meningitis (6%) Mucoceles Cavernous sinus thrombosis Encephalitis Brain abscess
60
What are the aims of midface trauma treatment?
Create a safe sinus Restore appearance
61
What are the indications of surgery in midface trauma?
Anterior table displacement with forehead deformity Displacement of posterior table with neurological injury Frontonasal duct involvement Non-surgical intervention for CSF leak to mitigate need for surgery
62
What special investigations are needed for a frontonasal duct injury?
CT Endoscopy Methylene blue on table
63
How is surgery carried out for a duct injury with a cosmetic defect?
Expose sinus lining and scrape in out Remove inner table to cranialise the sinus Block the duct with bone and tissu Reconstruct the outer table Aim to obliterate sinus cavity and obstruct duct outflow
64
How should a GDP manage facial trauma?
Be fast Analgesics Antibiotics for open fractures Liquid diet Immediate discussion with oral maxillofacial surgery (OMFS) team
65
What are the signs of midface and zygoma fractures?
Epistaxis CNV2 numbness Subconjunctival bleed Midface mobility Malocclusion Periorbital emphysema Diplopia Facial asymmetry CSF leak
66
What are the indications to treat cranio-orbital trauma?
CSF leak Deformity As part of facial reconstruction
67
What is a class I Le Fort fracture?
Horizontal separation of the maxilla from the rest of the facial skeleton
68
What is a class II LeFort fracture?
Pyramidal fracture - triangular shaped separation of the central face from the rest of the skull
69
What is a class III LeFort fracture?
Most severe - complete separation of the midface from the base of the skull
70
What instructions should a GDP give to pts with a zygomatic fracture?
No need for ABs Call OMFS - will be followed up 7-10 days No nose blowing Soft diet for comfort Give warning of a retrobulbar bleed
71
Give 4 examples of TMJ diseases
TMD Jaw dislocation Osteoarthritis Ankylosis
72
What are the components of TMD?
Muscular Mechanical - the joint Psychological - underlying cause Trauma - aetiology
73
What are the components of TMD aetiology?
Macrotrauma Microtrauma - chronic joint overloading Occlusal factors - eg deep bite, occlusal disharmony Anatomical factors
74
Why is the bilaminar zone important?
Resists the force of the lateral pterygoid preventing the articular disc from displacing
75
What is anterior disc displacement without reduction?
When the articular disc is displaced anteriorly but does not reduce back to its original provision upon opening and closing the jaw
76
What is anterior disc displacement with reduction?
Anterior displacement of the TMJ which reduces back into the normal position upon closing the jaw
77
Give examples of conservative TMD management
Counselling Pt education Medications - NSAIDs tricyclic antidepressants Pain management Joint rest - soft diet Bite raising appliance Physical therapy
78
What are the functions of a bite raising appliance?
Eliminates occlusal interferences Prevents the joint head from rotating so far posteriorly in the glenoid fossa Recudes loading on the TMJ
79
What is an arthrogram and why is it used?
Imaging technique where radiopaque material is injected around the condyle to look at the upper and lower compartment of the TMJ
80
Why is an MRI useful for TMD?
It shows the surrounding soft tissues and muscles of mastication well
81
What is arthroscopy and why is it useful?
Minimally invasive procedure where an arthroscope is inserted into a joint to look for abnormalities Good for detecting synovial membrane degeneration
82
What procedures can be done through arthroscopy?
Diagnosis Biopsy Lysis and lavage Disc reduction Eminectomy
83
What is arthrocentesis?
Alllowing washout of the joint space to remove inflammatory exudate
84
List 8 complications of TMJ surgery?
Broken instruments Middle ear perforation Haemorrhage Haemarthrosis Damage to CNV and CNVII Infection Extravasion Malocclusion
85
What is disc plication?
Recapturing the disc and putting it back into place
86
What is an eminectomy?
Removal of the articular eminence
87
What is a high condylar shave?
Shaving the top of the condyle
88
What is a condylotomy?
Creating a cut within the area of the condyle
89
What is a meniscectomy?
Removal of the articular disc
90
What is a condylectomy and when is it carried out?
Removing the entire condyle Eg - if tumour of big degenerative change or ankylosis of joint
91
What are the indications of TMJ reconstruction?
Joint destruction Ankylosis Developmental deformity Tumours
92
Name 6 surgical TMJ procedures?
Disc plication High condylar shave Eminectomy Meniscectomy Condylotomy Condylectomy
93
What is needed for a midface trauma diagnosis and what is commonly seen?
CT scan: - anterior table - posterior table - frontonasal duct - degree of displacement - brain injury or bleed

4 - misc (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions